Publications by authors named "C R Snell"

For 2 decades, the American Society of Clinial Oncology-College of American Pathologists human epidermal growth factor receptor 2 (HER2) testing criteria have included 0 and 1+ scores, but this distinction was inconsequential. Now, based on the DESTINY Breast-04 Trial (DB-04) results, for patients with metastatic breast cancer it underpins eligibility for trastuzumab-deruxtecan treatment. Discerning 0 from 1+ immunohistochemistry (IHC) staining is challenging, as HER2 low is not a biologically distinct cancer subset, there are no reference standards or controls, and second-tier tests (eg, in situ hybridization) do not apply.

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In classical Hodgkin lymphoma (cHL), responsiveness to immune-checkpoint blockade (ICB) is associated with specific tumor microenvironment (TME) and peripheral blood features. The role of ICB in nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is not established. To gain insights into its potential in NLPHL, we compared TME and peripheral blood signatures between HLs using an integrative multiomic analysis.

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The DESTINY Breast-04 trial revealed survival advantages of trastuzumab deruxtecan for women with metastatic HER2-low breast cancer (1+ or 2+ immunohistochemistry [IHC], without amplification). Although this trial applied the 2018 Americal Society of Clinial Oncology (ASCO)/College of American Pathologists (CAP) HER2 IHC scoring criteria, the subjectivity and imprecision in IHC scoring have raised concerns that patients' treatment may be misaligned. Our group of 9 experienced breast pathologists collated a deidentified set of 60 breast cancer core biopsies from 3 laboratories, evaluated with the Ventana 4B5 HER2 assay and mostly scored locally as HER2 0 or 1+.

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Background: Mobile health (mHealth) interventions have immense potential to support disease self-management for people with complex medical conditions following treatment regimens that involve taking medicine and other self-management activities. However, there is no consensus on what discrete behavior change techniques (BCTs) should be used in an effective adherence and self-management-promoting mHealth solution for any chronic illness. Reviewing the extant literature to identify effective, cross-cutting BCTs in mHealth interventions for adherence and self-management promotion could help accelerate the development, evaluation, and dissemination of behavior change interventions with potential generalizability across complex medical conditions.

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Article Synopsis
  • A study analyzed maternal risk factors associated with fetal alcohol spectrum disorders (FASD) by interviewing 2,515 mothers of first-grade students, focusing on health, demographics, and personal history.
  • Results showed that mothers of children with FASD were generally smaller, experienced higher pregnancy complications, had lower education levels, and faced more mental health challenges than mothers of typically developing children.
  • Regression analysis revealed that maternal variables accounted for a significant percentage of the variance in FAS diagnoses, suggesting these factors are important in understanding the risks associated with FASD.
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